Prophylactic statins: yes or no?
The many advances in cardiovascular diagnostic imaging technology, interventional procedures, drug development and elucidation of risk factors have resulted in a steady reduction in deaths from cardiovascular disease in most European countries. However CVD still remains the leading cause of mortality in Europe, with an annual toll of 4.3 million deaths, and experts predict that, with the ageing population as well as lifestyle changes that are increasing the prevalence of obesity and Type 2 diabetes, we are now facing a CVD epidemic that could overwhelm our health services.
Because of effective dissemination of information on CVD, people are increasingly aware of the modifiable risk factors, which include tobacco use and excessive alcohol consumption, a paucity of suitable exercise and a high fat and sugar diet. Many patients also know that statins, which reduce Low-Density Lipoprotein Cholesterol levels, can be taken for primary prevention of CVD; some even expect these drugs on demand. Indeed over 10% of UK residents now take statins, and The National Institute for Health and Care Excellence (NICE) is currently updating its guidelines to recommend statin therapy if the assessed risk of developing CVD within 10 years is 10% (the previous guidelines stated 20%). The American Heart Association and American College of Cardiology